Value of ultrasound assessment of diaphragm function combined with echocardiography in predicting weaning in mechanically ventilated patients

Abstract

ObjectiveTo evaluate the predictive value of diaphragmatic ultrasound with echocardiography in weaning from mechanical ventilation. MethodsThirty-seven mechanical ventilated patients were enrolled in Nanjing Jiangbei Hospital from November 2021 to September 2022. When meeting the standard of weaning from mechanical ventilation, during spontaneous breathing test （SBT）, diaphragmatic excursion （DE） was measured by anatomical M-mode ultrasound. Diaphragm contraction velocity were measured by tissue doppler, and cardiac function（EF and E/e′） were measured by echocardiography. The patients were divided into success group and failure group. The correlation between indicators and withdrawal outcomes was analyzed and the predictive value was explored by ROC curves. ResultsOf 37 patients, 3 were removed from the group, while out of 34 successfully enrolled patients, 24 were successfully removed from the machine （success group） and 10 were unsuccessful （failure group）. The differences in diaphragm contraction speed and EF between the two groups were not statistically significant （P＞0.05）, while the differences in DE and E/e′ were statistically significant （P＜0.05）. The AUC, sensitivity, 〖JP2〗and specificity was 0.808, 70.8% and 90.0% of DE, was 0.896, 70.8% and 100% of E/e′, was 0.958, 83.0% and 100% of DE combined with E/e′. ConclusionDE and E/e′can be used in predicting the ending in mechanical ventilation withdrawal. Combining the two can improve prediction sensitivity and specificity, which is stronger than single indicator prediction ability.

Keywords

• mechanical ventilation
• ventilator weaning
• diaphragmatic ultrasound
• diaphragmatic function
• echocardiography